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General NPI Number Information
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NPI Number | 1184467847
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Entity Type | Organization
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Legal Business Name | PRIME FACIAL PLASTIC SURGERY
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Dates
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Enumeration Date | 06/18/2024
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Last Update Date | 06/18/2024
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Provider Practice Location Address
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Address Line | 10285 LITTLE PATUXENT PKWY STE 250
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City | COLUMBIA
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State | MD
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Zip | 21044-3412
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Country | US
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Telephone | 301-302-7272
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Fax |
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Provider Business Mailing Address
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Address Line | 6050 BRICKER RD
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City | DAYTON
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State | MD
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Zip | 21036-1248
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JIGAR SITAPARA
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Credential | MD
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Telephone | 301-301-7272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number |
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License Number State |
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